Degree of food processing of household acquisition patterns in a Brazilian urban area is related to food buying preferences and perceived food environment.

Objective: This cross-sectional study examined the association between local food environment and consumers' acquisition of industrially processed food.

Methods: Households were randomly selected from 36 census tracts in Santos City, Brazil. Mothers, of varying economic status, who had children ages 10 or younger (n=538) were interviewed concerning: their household food acquisition of 31 groups of food and beverages, perceptions of their local food environment, food sources used, means of transportation used to travel to food sources, and socioeconomic status (SES). Food acquisition patterns were classified based on the degree of industrial food processing. Logistic regression models were fitted to assess the association between consumer behaviors and food acquisition patterns.

Results: The large variety of fruits and vegetables available in supermarkets was significantly related to lower odds of ultra-processed food purchases. After adjusting for sociodemographic characteristics, higher odds for minimally-processed food acquisition were associated with: frequent use of street fairs and specialized markets to purchase fruits and vegetables (OR 1.89, 95% CI 1.01-2.34), walking as the principal means of transportation to buy food (OR 1.58, 95% CI 1.08-2.30), and perceived availability of fresh fruits and vegetables in participants' neighborhood (OR 1.58, 95% CI 1.08-2.30). Household consumption of ultra-processed food was positively associated with the use of taxis as principal means of transportation to food sources (OR 2.35, 95% CI 1.08-5.13), and negatively associated with perceived availability of a variety of fruits and vegetables in participants' local neighborhood (OR 0.57, 95% CI 0.37-0.88).

Conclusion: The results suggest that food environment interventions aiming to promote acquisition of less processed food in settings similar to Santos, Brazil, may be most effective if they focus on increasing the number of specialized fresh food markets in local neighborhood areas, improve residents' awareness of these markets' availability, and provide appropriate transportation.